Journal of Feline Medicine and Surgery

Interpretation of ultrasonographical measurements requires an understanding of the source and the magnitude of variation. A substantial part of the variation can be attributed to the observer, the equipment or the animal. The aim of this study was to evaluate which adrenal gland measurement is the least variable within and between observers. Three experienced ultrasonographers examined six cats at three different times on the same day, more than 1 h apart, according to a strict scanning protocol. Seven ultrasonographical measurements were performed on each adrenal gland (maximal length on sagittal images, maximal height at the cranial and caudal poles on sagittal and transverse images, and maximal width of the cranial and caudal poles on transverse images). Height measurements in both planes showed the lowest variability within and between observers compared with length and width measurements. Descriptive ultrasonographical features, such as echogenicity of the gland, presence of hyperechoic spots or layering assessment, demonstrated satisfactory-to-good intra- and inter-observer agreement, whereas the shape assessment showed very poor inter-observer agreement. The results of this study describe a reliable scanning protocol that can be the basis for future adrenal ultrasonographical examinations for cats suspected of adrenal disease (eg, hyperaldosteronism, hyperadrenocorticism, sex hormone-producing tumours).

Little is known about the aetiology of inflammatory lower airway disease in cats. The aim of this study was to investigate the role of Mycoplasma species in cats with feline asthma (FA) and chronic bronchitis (CB). The study population consisted of 17 cats with FA/CB, and 14 sick cats without clinical and historical signs of respiratory disease, which were euthanased for various other reasons. Nasal swabs, nasal lavage and bronchoalveolar lavage fluid (BALF) samples were taken from patients from both groups. Mycoplasma species culture with modified Hayflick agar and Mycoplasma polymerase chain reaction (PCR) were performed on all samples followed by sequencing of all Mycoplasma species-positive samples for differentiation of subspecies. PCR testing detected significantly more Mycoplasma species-positive BALF samples than Mycoplasma culture (P = 0.021). When cats with oropharyngeal contamination were excluded from comparison, the numbers of Mycoplasma species-positive BALF samples in the group with FA/CB (6/17) and the control group (4/9) were not significantly different (P = 0.6924). While all nasal samples of the cats with FA/CB were negative for Mycoplasma organisms, five samples in the control group (P = 0.041) were positive on PCR. Sequencing revealed Mycoplasma felis in all PCR-positive samples. Mycoplasma species can be detected in the lower airways of cats with FA/CB, as well as in the BALF of sick cats without respiratory signs. Further studies are warranted to investigate the possibility that Mycoplasma species represent commensals of the lower respiratory tract of cats.

Eosinophilic enteritis (EE) in cats is poorly characterized. The aim of the current study was to retrospectively evaluate the clinical and ultrasonographic findings in cats with histologic evidence of eosinophilic inflammation on gastrointestinal biopsy. Twenty-five cats with tissue eosinophilia on surgical (10) or endoscopic (15) biopsy of the gastrointestinal tract, having an abdominal ultrasound performed within 48 h of biopsy acquisition, were enrolled. History, clinical presentation, clinical pathology and abdominal ultrasound findings were reviewed. Intestinal biopsies were evaluated by a single pathologist and separated into two groups based on the degree of eosinophilic infiltrate: mild (<10 eosinophils/high-power field [HPF], 11/25 cats), or moderate/marked (>10 eosinophils/HPF, 14/25 cats). The former were considered primary lymphoplasmacytic or lymphocytic inflammatory bowel disease (LPE) with subtle eosinophilic infiltrates, and the latter to have EE. Signalment, history and clinical signs were similar in all cats. Only cats with EE (6/14) had palpably thickened intestines. The only distinguishing clinicopathological feature of cats with EE was the presence of peripheral eosinophilia (6/14). On ultrasound, when compared with cats with LPE, cats with EE had a greater mean jejunal wall thickness (3.34 mm ± 0.72 mm vs 4.07 mm ± 0.58 mm, respectively) and an increased incidence of thickening of the muscularis layer (1/11 and 11/14, respectively). In conclusion, ultrasonographic evidence of a prominent intestinal muscularis layer, palpably thickened intestines and peripheral eosinophilia can serve as biomarkers for the presence of EE in cats with chronic intestinal signs.

Body condition scoring (BCS) provides a readily available technique that can be used by both veterinary professionals and owners to assess the body condition of cats, and diagnose overweight or underweight conditions. The objective of this study was to evaluate a five-point BCS system with half-point delineations using dual-energy x-ray absorptiometry (DXA). Four evaluators (a veterinarian, veterinary technician, trained scorer and untrained scorer) assessed 133 neutered adult cats. For all scorers, BCS score was more strongly correlated with percent body fat than with body weight. Percent body fat increased by approximately 7% within each step increase in BCS. The veterinarian had the strongest correlation coefficient between BCS and percent fat (r = 0.80). Mean body fat in cats classified as being in ideal body condition was 12 and 19%, for 3.0 and 3.5 BCS, respectively. Within BCS category, male cats were significantly heavier in body weight than females within the same assigned BCS category. However, DXA-measured percent body fat did not differ significantly between male and female cats within BCS category, as assigned by the veterinarian (P >0.13). Conversely, when assessed by others, mean percent body fat within BCS category was lower in males than females for cats classified as being overweight (BCS >4.0). The results of this study show that using a BCS system that has been validated within a range of normal weight to moderately overweight cats can help to differentiate between lean cats and cats that may not be excessively overweight, but that still carry a higher proportion of body fat.

The incidence of cefotaximase (CTX-M)-type extended-spectrum β-lactamase (ESBL)-producing Escherichia coli has increased dramatically in humans and animals since the middle of the last century. E coli that produce CTX-M β-lactamase represent a major cause of urinary tract infections, and pose a significant therapeutic challenge to both human and veterinary medicine. As data on uropathogenic CTX-M-producing strains in cats are limited, the aim of this study was to describe the genetic character and antibiotic resistance phenotypes of CTX-M-producing E coli isolated from cats with cystitis. Seven of 15 E coli bacteria isolated from 138 urine samples had the CTX-M gene and were therefore included in this study. These isolates were screened by polymerase chain reaction for the presence of 14 extra-intestinal virulence factors, class 1 and class 2 integrons, and to identify their phylogenetic groups. Multi-locus sequence typing (MLST) of the strains and susceptibility testing (disc diffusion method) were also performed. Virulence factor iutA was the most frequent determinant identified (86.7%), and the majority of CTX-M-producing strains (n = 5) carried class 1 integrons. MLST allowed us to discriminate four known sequence types (ST131, ST555, ST602, ST155) and three novel sequence types (ST3847, ST3848, ST4181). To the best of our knowledge, this is the first study to report uropathogenic CTX-M-producing E coli ST131 in cats in Italy. Accurate diagnostics and prudent use of antimicrobials are recommended to avoid the spread of multidrug-resistant pathogens in veterinary medicine and to prevent their transmission to humans.

The qualitative and quantitative aspects of femoral artery blood flow waveform spectra were evaluated in 15 male and 15 female Persian and mixed breed domestic cats (Felis catus), which were healthy and not sedated, using duplex Doppler ultrasonography (DDU). Spectral Doppler demonstrated a biphasic characteristic in 16 (53.34%) of the animals evaluated, and a triphasic characteristic in the 14 (46.66%) remaining animals. The systolic blood pressure and heart rate values were within the normal range for the species. The quantitative parameters evaluated, based on the spectral Doppler, were as follows: systolic velocity peak (SVP), recent diastolic velocity peak (RDVP), end diastolic velocity peak (EDVP), mean velocity (MV), integral velocity time (ITV), artery diameter (AD), femoral flow volume (FFV), pulsatility index (PI), resistive index (RI), systolic peak acceleration time (AT) and deceleration time (DT). The respective mean values were: 36.41 ± 7.33 cm/s, 4.69 ± 0.90 cm/s, 10.74 ± 2.74 cm/s, 23.06 ± 4.86 cm/s, 3.91 ± 1.05 cm, 0.17 ± 0.04 cm, 0.11 ± 0.08 cm³, 3.85 ± 0.19, 1.40 ± 0.20, 39.84 ± 7.38 ms, and 114.0 ± 22.15 ms. No significant differences were found between males and females. The analyses carried out on the femoral artery flow spectrum obtained by DDU showed that it is easy to use and highly tolerated in non-sedated, healthy cats. It appears that DDU may be a useful diagnostic technique, but further studies are needed to evaluate how it compares with invasive telemetric methodology or high-definition oscillometric waveform analytic techniques.

The purpose of this retrospective study of 20 client-owned cats was to describe the clinical signs, surgical interventions, histological features, stage and treatments of primary lung tumors removed by surgical excision, and to determine which factors significantly influence survival. Any cat that underwent surgical resection of a primary lung tumor between 2000 and 2007 was included in the study. Patient records were reviewed and signalment, clinical signs, preoperative diagnostics, surgical findings and histopathological results recorded. Histological reports were reviewed and scored using World Health Organization criteria. The Kaplan–Meier test was used to evaluate each potential prognostic factor with survival. Twenty cats met the inclusion criteria. The presence of clinical signs (such as dyspnea) at the time of diagnosis (P = 0.032), pleural effusion (P = 0.046), stage M1 (P = 0.015), and moderately and poorly differentiated tumors on histopathology (P = 0.011) were factors that were significantly correlated with reduced survival times. The median survival time of the 20 cats was 11 days. Cats presenting with no clinical signs had a median survival time of 578 days post-surgery vs 4 days post-surgery when presented with clinical signs. Cats staged T1N0M0 lived longer than cats at other stages (P = 0.044). Of the cats that survived to the time of suture removal, median survival time was 64 days. The results indicate that the presence of clinical signs, pleural effusion, moderately and poorly differentiated tumors on histopathology, evidence of metastasis and any stage beyond T1N0M0 are negative prognostic indicators for cats with primary lung tumors. The findings demonstrate that cats that presented with clinical signs, pleural effusion, any stage other than T1N0M0, or moderately and poorly differentiated tumors on histopathology had a poor prognosis. Therefore, extensive preoperative diagnostics, including computed tomography scans, should be performed before considering surgical intervention in these cats. These findings may be used to guide therapeutic decision-making in cats diagnosed with primary lung tumors.

The objective of this study was to determine the outcome of cats with ureteric obstruction managed with double pigtail ureteric stents and to document the incidence of lower urinary tract signs at long-term follow-up. Data were obtained retrospectively from the medical records (2009–2012) of 26 cats that underwent ureteric stent placement. Owners were contacted for follow-up, and a quality of life questionnaire completed. Survival to discharge after stent placement was 85% (22/26). Prevalence of postoperative uroabdomen necessitating further surgery was 15% (4/26). Stents were replaced 4–28 months after the initial surgery in four cats because of migration, fracture, encrustation causing luminal obstruction or sterile cystitis, respectively. Nine cats were alive at follow-up, which was 3–28 months after the original surgery. Nine cats had azotaemic chronic kidney disease and nine had signs related to sterile cystitis; three of these cats were euthanased as a result of the severity of the signs. Preoperative serum creatinine of the survivors (9.4 mg/dl, n = 9) was not significantly different from that of the non-survivors (6.5 mg/dl, n = 13; P = 0.295). Quality of life was assigned a mean score of 8/10. Median survival of cats following discharge was 419 days (range 44–994 days). Signs consistent with sterile cystitis affected 35% of cats. It was concluded that ureteric stent placement in cats was associated with a 15% mortality rate before hospital discharge. Long-term management of ureteric stents is associated with a high rate of lower urinary tract signs.

Twenty healthy cats (group 1) with clinically normal ears, 15 cats with systemic disease (group 2) and 15 allergic cats (group 3) were included in a prospective study. The experimental unit was the ear. A clinical score was established for each ear canal after otoscopic examination. Microbial population was assessed on cytological examination of smears performed with the cotton-tipped applicator smear technique. Fungal population was significantly more prominent in allergic cats (P <0.001) and in diseased cats compared with healthy cats (P <0.02). Bacterial population was significantly higher in allergic cats than in healthy cats (P <0.001) and cats suffering from systemic disease (P <0.001). Bacterial overgrowth was also higher in cats with systemic disease than healthy cats. In cats from group 2, only fungal overgrowth was associated with otitis severity. In group 3, only bacterial overgrowth was associated with otitis severity.

Mycoplasma species are common inhabitants of the feline oral cavity, and so likely contaminate many cat bite abscesses. The objectives of this study were to determine whether Mycoplasma species are common contaminants of cat bite abscesses and whether they are are associated with β-lactam-resistant clinical disease. Twenty-six privately owned cats with clinical evidence of an abscess suspected to be from a cat bite were included in the study. Samples from each cat were evaluated by aerobic and anaerobic culture, as well as Mycoplasma species culture and polymerase chain reaction (PCR). All cats were initially treated with appropriate wound management and were administered an antibiotic of the β-lactam class (amoxicillin, amoxicillin clavulanate or cefovecin sodium). Mycoplasma species DNA was amplified by PCR from 4/26 samples (15.4%); one of these cases was concurrently culture positive. Adequate DNA for sequencing was present for 2/4 positive PCR samples; one was most homologous with Mycoplasma felis, and the other was most homologous with Mycoplasma equigenitalium and Mycoplasma elephantis. Of the 26 cats, 25 responded to the initial treatment by day 7. The cat that failed initial treatment was positive for M equigenitalium or M elephantis DNA on days 0 and 12, and ultimately responded to administration of enrofloxacin and clindamycin. The results suggest that while Mycoplasma species can contaminate cat bite abscesses, routine wound management and β-lactam antibiotic therapy is adequate for treatment in most cases of abscess. However, as Mycoplasma species infections do not respond to β-lactam class antibiotic therapy, these organisms should be on the differential list for cats with abscesses that fail treatment with this antibiotic class.

All previous studies on feline ischaemic myelopathy (IM) have reported an acute onset of a single event with no recurrence of clinical signs. This study aimed to evaluate clinical and long-term follow-up data in cats presumptively diagnosed with cervical IM in the territory of the ventral spinal artery (VSA). Eight cats (four females and four males) were included with a mean age of 14 years and 2 months. Neurological status at the time of presentation ranged from ambulatory tetraparesis to tetraplegia with nociception present. Six cats had marked cervical ventroflexion. All eight cats were diagnosed with one or more concurrent medical conditions, including chronic kidney disease (n = 2), hypertrophic cardiomyopathy (n = 2) and hypertension (n = 6). Median time to ambulation was 5.7 days (range 2–14 days). Long-term follow-up ranged from 7 months to 3 years and 3 months (median 1 year and 2 months). Five cats had no reported recurrence of clinical signs and 3/8 had a chronic relapsing disease course. One cat had an acute recurrence of clinical signs 4 months after the first event and was euthanased. Two cats had acute onsets of suspected intracranial infarctions, one of which had further suspected intracranial infarcts every 3 months and was euthanased after one of these. This study highlights the importance of performing ancillary diagnostic tests in older cats presenting with IM, particularly when VSA embolisation is suspected.

Lagochilascariasis, a parasitic disease little known in Brazil, is caused by an ascarid nematode that has a peculiar life cycle, with a predilection site for the cervical region in the final hosts: humans, cats and dogs. We aimed to record the occurrence of Lagochilascaris minor in domestic cats from rural areas in the Municipality of Pelotas, Rio Grande do Sul State, Brazil, with reports of clinical signs and the treatment applied.

An 11-year-old spayed female domestic shorthair cat was evaluated for anorexia, lethargy and weight loss of 6 days’ duration. Bilateral mydriasis, absent menace response, slow-to-absent pupillary light reflexes, bilateral retinal detachment, intermittent horizontal nystagmus, intermittent ventral strabismus and systemic hypertension were present. Biochemical analysis revealed severe hyponatremia, severe hypochloremia and mild hypokalemia. Multifocal central nervous system disease was suspected based on optic, trigeminal sensory (ophthalmic branch), vestibulocochlear and possible oculomotor nerve dysfunction. Thoracic radiographs showed mild cardiomegaly without evidence of congestive heart failure. Ultrasound revealed mild pleural and peritoneal effusion. A cause of the severe hyponatremia was not identified, and it persisted despite fluid therapy. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) was suspected as the cause of hyponatremia. Humane euthanasia was elected owing to continued clinical decline. Serum hyposmolality, urine hyperosmolality, natriuresis and lack of confirmed renal, thyroid and pulmonary disease aided in the presumed diagnosis of SIADH. Post-mortem histopathology of the brain revealed degeneration of the hypothalamus and optic tracts, along with a prominent fluid-filled craniopharyngeal duct (putative Rathke’s cleft cyst) separating the pars distalis and the pars intermedius. The hypothalamic degeneration, possibly secondary to a Rathke’s cleft cyst, was hypothesized to be the cause of presumptive SIADH in the patient. Although rare in occurrence, Rathke’s cleft cyst should be included as a differential diagnosis in dogs and cats with signs of pituitary dysfunction.

A 2-month-old kitten exhibited simultaneously an imperforate anus, hypospadias, rectourethral fistula and genital dysgenesis (penis restricted to the glans, absence of prepuce and bifid scrotum). Surgical correction consisted of separation of the urinary and digestive tracts, perineal urethrostomy and connection of the rectum to the newly made anal opening. Pathological examination of the testes, conventionally removed at 9 months of age, showed no mature spermatozoa and underdevelopment of germ and Leydig cells. In humans, the absence of an anal opening in association with abnormal sexual development defines the urorectal septum malformation sequence. Here, we describe the first case of this syndrome in a kitten with a normal male karyotype (38,XY) and a normal coding sequence for the SRY gene. Both the rectourethral fistula and observed genital abnormalities might have been induced by a disturbance in the hedgehog signalling pathway. However, although four polymorphic sites were identified by DHH gene sequencing, none cosegregated with the malformation.

A 7-year-old, castrated male, domestic shorthair cat presented with generalized exfoliative dermatitis, lethargy, anorexia and weight loss. Multiple skin scrapings taken at the time did not reveal any abnormalities. Skin histopathological examination was consistent with sebaceous adenitis or exfoliative dermatitis caused by an underlying thymoma (thymoma-associated feline exfoliative dermatitis). Thoracic radiographs revealed a cranial mediastinal mass, which was removed surgically. Histopathological examinations indicated that it was a thymoma. Within 90 days of surgery, the cutaneous signs had resolved, suggesting a causal relationship between the thymoma and the skin disease. Recurrence of thymoma was detected 24 months after surgery.